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A Short Physical Performance Battery Assessing Lower Extremity Function: Association With Self-Reported Disability and Prediction of Mortality and Nursing Home Admission

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A short battery of physical performance tests was used to assess lower extremity function in more than 5,000 persons age 71 years and older in three communities. Balance, gait, strength, and endurance were evaluated by examining ability to stand with the feet together in the side-by-side, semi-tandem, and tandem positions, time to walk 8 feet, and time to rise from a chair and return to the seated position 5 times. A wide distribution of performance was observed for each test. Each test and a summary performance scale, created by summing categorical rankings of performance on each test, were strongly associated with self-report of disability. Both self-report items and performance tests were independent predictors of short-term mortality and nursing home admission in multivariate analyses. However, evidence is presented that the performance tests provide information not available from self-report items. Of particular importance is the finding that in those at the high end of the functional spectrum, who reported almost no disability, the performance test scores distinguished a gradient of risk for mortality and nursing home admission. Additionally, within subgroups with identical self-report profiles, there were systematic differences in physical performance related to age and sex. This study provides evidence that performance measures can validly characterize older persons across a broad spectrum of lower extremity function. Performance and self-report measures may complement each other in providing useful information about functional status.
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... The SPPB clinical tool was chosen to measure physical function (37). The SPPB consists of 3 subtests: (1) the standing balance test, (2) the gait speed test, and (3) the 5 times sit-tostand test. ...
... The SPPB consists of 3 subtests: (1) the standing balance test, (2) the gait speed test, and (3) the 5 times sit-tostand test. The total SPPB score ranges from 0 to 12, with higher scores reflecting better functional status, and it is divided into 4 categories: from 0 to 3, from 4 to 6, from 7 to 9, and from 10 to 12 points (37). It has been proposed that scores ≤9 points might help to detect frail older adults (38,39). ...
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Background The Charlson Comorbidity Index (CCI) is the most widely used method to measure comorbidity and predict mortality. There is no evidence whether malnutrition and/or poor physical function are associated with higher CCI in hospitalized patients. Therefore, this study aimed to (i) analyze the association between the CCI with nutritional status and with physical function of hospitalized older adults and (ii) examine the individual and combined associations of nutritional status and physical function of older inpatients with comorbidity risk.MethodsA total of 597 hospitalized older adults (84.3 ± 6.8 years, 50.3% women) were assessed for CCI, nutritional status (the Mini Nutritional Assessment-Short Form [MNA-SF]), and physical function (handgrip strength and the Short Physical Performance Battery [SPPB]).ResultsBetter nutritional status (p < 0.05) and performance with handgrip strength and the SPPB were significantly associated with lower CCI scores among both men (p < 0.005) and women (p < 0.001). Patients with malnutrition or risk of malnutrition (OR: 2.165, 95% CI: 1.408–3.331, p < 0.001) as well as frailty (OR: 3.918, 95% CI: 2.326–6.600, p < 0.001) had significantly increased the risk for being at severe risk of comorbidity. Patients at risk of malnutrition or that are malnourished had higher CCI scores regardless of being fit or unfit according to handgrip strength (p for trend < 0.05), and patients classified as frail had higher CCI despite their nutritional status (p for trend < 0.001).Conclusions The current study reinforces the use of the MNA-SF and the SPPB in geriatric hospital patients as they might help to predict poor clinical outcomes and thus indirectly predict post-discharge mortality risk.
... Prior to the exergame try-out, the SPPB was administered. The SPPB assesses gait speed, balance, and lower limb strength (Guralnik et al., 1994;Fox et al., 2014). It is composed of three subtests; a standing balance test, a short 4-m walk at usual pace , and 5 chair rises. ...
... The reliability of the SPPB is high in older adults with MNCD, with intraclass correlation coefficient values ranging between 0.82 and 0.92 (Guralnik et al., 2000;Ostir et al., 2002;Olsen and Bergland, 2017). The SPPB is highly predictive for disability in older adults (Guralnik et al., 2000) and the internal consistency is acceptable (Cronbach's α = 0.76) (Guralnik et al., 1994). ...
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Technological Advancements in Aging and Neurological Conditions to Improve Physical Activity, Cognitive Functions, and Postural Control.
... We created binary race (minority/non-minority), education (above/below college degree), and income (above/below 80% AMI) variables. An additional measure of physical function was assessed objectively at baseline using the Short Physical Performance Battery (SPPB) test, which includes a series of repeated chair stands, balance tests and a measured walk [55,56]. Participants were asked to bring all medications to the measurement visit and medication names, dosage, and frequency were recorded by study staff. ...
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... Participants ability to maintain balance in three different stance positions (side-by-side, semi-tandem, and tandem) was assessed in accordance with the Short Physical Performance Battery (SPPB) protocol [21]. The ability to maintain balance in the tandem stance position with the eyes closed was also assessed. ...
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... Each component is scored from 0 to 4 points. A sum score (0-12 points) is calculated with higher scores indicating better functional capacity (Guralnik et al., 1994). A score of <10 is associated with an increased risk of ADL and mobility-disability as well as all-cause mortality (Guralnik et al., 2000;Pavasini et al., 2016). ...
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